<form method="post" name="customer_form" action="?option=<?php echo COMPONENT_NAME;?>&page=customers&action=new">
<table width="100%" border="0">
  <tr class="HeaderTr">
	<td colspan="3"><b>Customer Information</b></td>
  </tr>
  <tr>
    <td>Unit Manager</td>
    <td width="40%"><input type="checkbox" name="customer[user_type]" <?php echo ($customer->user_type == "manager" ? 'checked' : '');?> /></td>
    <td rowspan="15" valign="top">&nbsp;</td>
  </tr>
  <tr>
    <td width="15%">Name</td>
    <td>
    	<select name="customer[title]">
        <option value="Mr" <?php echo ($customer->title == "Mr" ? 'selected="selected"' : '');?>>Mr</option>
        <option value="Mrs" <?php echo ($customer->title == "Mrs" ? 'selected="selected"' : '');?>>Mrs</option>
        <option value="Miss" <?php echo ($customer->title == "Miss" ? 'selected="selected"' : '');?>>Miss</option>
        <option value="Ms" <?php echo ($customer->title == "Ms" ? 'selected="selected"' : '');?>>Ms</option>
        </select>
        <input type="text" name="customer[firstname]" value="<?php echo $customer->firstname;?>" />
        <input type="text" name="customer[surname]" value="<?php echo $customer->surname;?>" />
    </td>
  </tr>
  <tr>
    <td>Address</td>
    <td><input type="text" name="customer[address1]" size="45" value="<?php echo $customer->address1;?>" /></td>
  </tr>
  <tr>
    <td>Other address</td>
    <td><input type="text" name="customer[address2]" size="45" value="<?php echo $customer->address2;?>" /></td>
  </tr>
  <tr>
    <td>Country</td>
    <td><input type="text" name="customer[country]" value="<?php echo $customer->country;?>" /></td>
  </tr>
  <tr>
    <td>City</td>
    <td><input type="text" name="customer[city]" value="<?php echo $customer->city;?>" /></td>
  </tr>
  <tr>
    <td>Post Code</td>
    <td><input type="text" name="customer[postcode]" value="<?php echo $customer->postcode;?>" /></td>
  </tr>
  <tr>
    <td>State</td>
    <td><input type="text" name="customer[state]" value="<?php echo $customer->state;?>" /></td>
  </tr>
  <tr>
    <td>Telephone</td>
    <td><input type="text" name="customer[telephone]" value="<?php echo $customer->telephone;?>" /></td>
  </tr>
  <tr>
    <td>Mobile</td>
    <td><input type="text" name="customer[mobile_phone]" value="<?php echo $customer->mobile_phone;?>" /></td>
  </tr>
  <tr>
    <td>Email</td>
    <td><input type="text" name="customer[email]" size="30" value="<?php echo $customer->email;?>" /></td>
  </tr>
  <tr>
    <td>Notification Email</td>
    <td><input type="text" name="customer[notification_email]" value="<?php echo $customer->notification_email;?>" size="30" /></td>
  </tr>
  <tr>
    <td>Username</td>
    <td><input type="text" name="customer[username]" value="<?php echo $customer->username;?>" /></td>
  </tr>
  <tr>
    <td>Password</td>
    <td><input type="text" name="customer[password]" value="<?php echo $customer->password;?>" /></td>
  </tr>
  <tr>
    <td>Notes</td>
    <td><textarea name="customer[notes]" cols="30" rows="5"><?php echo $customer->notes;?></textarea></td>
  </tr>
  <tr>
	<td>
		<input type="hidden" name="form" value="create_or_edit_customer">
	</td>
  </tr>
</table>
</form>
<?php $KToolBar->addLink('<a href="#" onclick="document.customer_form.submit()"><img border="0" alt="Save" src="images/save_f2.png"/><br />Save</a>');?>
<?php $KToolBar->addLink('<a href="?option='.COMPONENT_NAME.'&page=customers"><img border="0" alt="Cancel" src="images/cancel_f2.png"/><br />Cancel</a>');?>
